Insurance Industry and the ACA

Fact: The Insurance Industry is the biggest licensed gambling casino
in the world!
Let me explain:Every time you pay any insurance premium you are placing a bet that
something BAD is going to happen to you and the insurance company is
accepting your bet in the belief that the odds are that nothing bad is
going to happen to you. The Insurance Companies do NOT make any money
on the premiums they collect. They make their profits investing your
premiums in the money markets of a free economy, such as the stock
market, real estate, CD’s etc.
The people who do the calculations relative to the risk the insurance
companies are taking are called “actuaries.” Actuaries are the
“bookies” for the insurance companies just like the bookies in Las
Vegas who figure the odds on sports betting. Is there something wrong
with that? Of course not — it’s a business! Sometimes they are right
and sometimes they are wrong. As long as they are right more than 51
percent of the time, they are winners. Judging by the success of most
of the insurance companies, their actuaries are doing a good job.
Actuaries, just like bookies, are very smart people when it comes to
risk assessment. Insurance actuaries recalculate risks on an ongoing
basis. Particularly, life and health insurance risk assessment is a
very dynamic science and is based on constantly changing metrics
dealing with life expectancy, pharmaceutical research and general
health care availability. That is why premiums constantly change and
are being adjusted on a regular basis.
So, now let me apply this wisdom to our Healthcare debacle.
The Governments line to sell the Affordable Care Act to the American
people was: There are too many people that would go bankrupt in the
event of a catastrophic illness or accident because they would not be
able to pay for the medical costs. And that is absolutely true — but
what are the odds that this will happen to a lot of people? Not very
high. That is why the Insurance industry is offering healthcare plans
with enormous maximum multimillion-dollar upper limits but a very high
deductible. Basically they are telling us, if you can afford to pay a
high deductible, we will offer you a plan for a rock bottom low
monthly premium. A policy like that will take care of any catastrophic
accident or terminal cancer diagnosis at a very low monthly cost, but
it will not pay for a doctor visit to alleviate the pain of a common
cold. Again, the odds are that the insurance company will not have to
pay claims very often because they have the experience to know that.
But then there are the people who will run to their family doctor with
the onset of a common cold that no doctor can cure. It will have to
run its course, but they expect their insurance company to pay for the
first penny of this doctor visit. Not only that, but with a zero
deductible, they don’t really care how much the doctor or the hospital
is charging for the service. There is absolutely NO incentive for a
doctor or hospital to be competitive. If you want a zero deductible,
your monthly health insurance premium will go up! And those metrics
are true for private insurance companies as well as
government-sponsored insurance: it is just a fact of life! The same
holds true for the requirement to cover all pre-existing conditions.
Should they be covered? The premiums for EVERYONE will go up to cover
the additional risk. And again, the “bookies” of the insurance
experts, the actuaries, can give us the exact cost. Should the
government subsidize premiums for people with pre-existing conditions
in the form of tax credits? Maybe that would be an answer without
affecting EVERYONE and at a much lower cost to society and the
taxpayer.
No one in the world is more knowledgeable about health insurance than
the very companies that are in business to sell health insurance. Did
the administration consult with the health insurance industry before
the rollout of the ACA — and if not, why not? Maybe they would have
discovered that the Insurance companies could not afford to comply
with the law AND stay in a profitable business! HHS would have been
aware of the fact that the insurance companies would have to cancel
millions of policies in order not to lose a lot of money by complying
with the law.
Here is my suggestion to solve the health insurance debacle in the USA:
Let’s treat it in the same way as we treat Medicare and Medicaid right
now, except in reverse. In other words, have the government help every
working person to secure a healthcare policy to cover a catastrophic
event and encourage the individual to cover the bulk of average,
everyday medical expenses with an additional policy of their choice of
deductible. With a nearly 100 percent participation, I bet the
insurance industry would be eager to supply such a catastrophe policy
at a bargain basement cost.
Let me briefly address the notion that Medicare is FREE to retired
people. It is NOT! Retired folks over the age of 64 right now are
eligible for Medicare and [possibly] Medicaid. But they still only get
80 percent healthcare coverage, which, incidentally, is not exactly
FREE. Medicare-eligible folks pay about $104 per month out of their
Social Security check for that 80 percent healthcare coverage and they
still have to purchase a supplemental policy to cover the other 20
percent of their healthcare costs. That premium typically runs from
$150 to $200 per month for a combined total of about $300 per month
per person — and that is a pretty good chunk out of their $1000 a
month Social Security check (30%). Very wealthy individuals do not
even need to purchase such a supplemental policy if they believe they
can handle the 20 percent that is not covered by Medicare out of
pocket.
We could apply the same logic to universal healthcare or the ACA, but
in reverse:
A catastrophic healthcare insurance policy would be required for every
citizen of the USA and would be deducted from the paycheck, just like
income tax or FICA. And as mentioned above, with a nearly 100 percent
participation, such a policy would be available to everyone at a very
low cost, either paid at his or her expense or by an employer. The
policy would have a relatively high deductible but an upper limit high
enough to cover the most catastrophic hospitalization expenses. As
mentioned before, the health insurance industry knows from experience
that the odds of catastrophic illnesses or accidents are low,
therefore those policies are relatively inexpensive with their high
deductibles. In the rare event of a catastrophic illness or accident,
the government would cover the high deductible as part of society’s
cost to finance such a program and the insurance would cover the
balance. That would take care of the notion that a citizen would have
to go bankrupt because of a catastrophic illness or accident. If an
individual wants to have more than catastrophic coverage, there are a
multitude of healthcare policies on the market with moderate to no
deductibles that can be purchased by the individual or their employer
to fit anyone’s budget. With this plan, irresponsible abuse of health
insurance coverage would be eliminated or at least only perpetrated at
the insured’s expense.
Another aspect of lowering healthcare costs is the amount of money
that can be sued for, AKA Tort Reform.
Folks, life is a gamble! Let’s play smart in the Mega Casino of Health
Insurance!

Donations

LasVegasTribune.com has a handful of honest hardworking editors and researchers. We are working diligently to bring you the truth no matter the cost. We have no membership fees and have no plans for it in the future. We rely on the compassion and dedication of our faithful volunteers and donations from our loyal readers.

Please donate as much as you feel comfortable. We have multiple donation values for your convenience as well as donation you can enter your own value.

We thank you for your support, and please only donate what you can afford.